中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2009年
6期
353-356
,共4页
沈兴平%邹森彪%吴豪杰%张岩
瀋興平%鄒森彪%吳豪傑%張巖
침흥평%추삼표%오호걸%장암
高糖危象%瘦素%氧化应激
高糖危象%瘦素%氧化應激
고당위상%수소%양화응격
hyperglycemia crisis%leptin%oxidative stress
目的 探讨高糖危象患者血清瘦素水平变化及与氧化应激的关系.方法 选择糖尿病酮症酸中毒和非酮症高血糖患者96例,静脉泵入胰岛素0.1 U·kg1·h1,同时给予补液、对症治疗以及胃肠和静脉营养.检测高糖危象患者治疗前及病情缓解时(72 h)血清瘦素、超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量、总抗氧化能力(TAC)和8-异前列腺素F2α(8-iso-PGF2α)水平.另外选择35例健康体检者作为对照组.结果 高糖危象患者治疗前SOD、TAC和瘦素水平均显著低于健康对照组,而MDA和8-iso-PGF2a均显著高于健康对照组(P均<0.05);高糖危象患者治疗后SOD、TAC和瘦素均显著高于治疗前,而MDA和8-iso-PGF2a均显著低于治疗前(P均<0.05).高糖危象患者治疗前瘦素与MDA呈显著正相关(r=0.38,P<0.05),治疗后瘦素与MDA和8-iso-PGF2a呈显著负相关(r1=-0.35,r2=-0.37,P均<0.05).多元逐步回归分析显示MDA和8-iso-PGF2α均为影响血清瘦素水平的显著因素.结论 高糖危象患者血清瘦素水平明显下降,且与氧化应激有关.
目的 探討高糖危象患者血清瘦素水平變化及與氧化應激的關繫.方法 選擇糖尿病酮癥痠中毒和非酮癥高血糖患者96例,靜脈泵入胰島素0.1 U·kg1·h1,同時給予補液、對癥治療以及胃腸和靜脈營養.檢測高糖危象患者治療前及病情緩解時(72 h)血清瘦素、超氧化物歧化酶(SOD)活性、丙二醛(MDA)含量、總抗氧化能力(TAC)和8-異前列腺素F2α(8-iso-PGF2α)水平.另外選擇35例健康體檢者作為對照組.結果 高糖危象患者治療前SOD、TAC和瘦素水平均顯著低于健康對照組,而MDA和8-iso-PGF2a均顯著高于健康對照組(P均<0.05);高糖危象患者治療後SOD、TAC和瘦素均顯著高于治療前,而MDA和8-iso-PGF2a均顯著低于治療前(P均<0.05).高糖危象患者治療前瘦素與MDA呈顯著正相關(r=0.38,P<0.05),治療後瘦素與MDA和8-iso-PGF2a呈顯著負相關(r1=-0.35,r2=-0.37,P均<0.05).多元逐步迴歸分析顯示MDA和8-iso-PGF2α均為影響血清瘦素水平的顯著因素.結論 高糖危象患者血清瘦素水平明顯下降,且與氧化應激有關.
목적 탐토고당위상환자혈청수소수평변화급여양화응격적관계.방법 선택당뇨병동증산중독화비동증고혈당환자96례,정맥빙입이도소0.1 U·kg1·h1,동시급여보액、대증치료이급위장화정맥영양.검측고당위상환자치료전급병정완해시(72 h)혈청수소、초양화물기화매(SOD)활성、병이철(MDA)함량、총항양화능력(TAC)화8-이전렬선소F2α(8-iso-PGF2α)수평.령외선택35례건강체검자작위대조조.결과 고당위상환자치료전SOD、TAC화수소수평균현저저우건강대조조,이MDA화8-iso-PGF2a균현저고우건강대조조(P균<0.05);고당위상환자치료후SOD、TAC화수소균현저고우치료전,이MDA화8-iso-PGF2a균현저저우치료전(P균<0.05).고당위상환자치료전수소여MDA정현저정상관(r=0.38,P<0.05),치료후수소여MDA화8-iso-PGF2a정현저부상관(r1=-0.35,r2=-0.37,P균<0.05).다원축보회귀분석현시MDA화8-iso-PGF2α균위영향혈청수소수평적현저인소.결론 고당위상환자혈청수소수평명현하강,차여양화응격유관.
Objective To investigate the relationship between the levels of serum leptin and oxidative stress in patients with hyperglycemia crisis. Methods A total of 96 patients with diabetic ketoaeidosis (DKA) and nonketotic hyperglycemia (NKH) were treated on a low-dose insulin protocol using intravenous infusion of insulin with the established rate of 0.1U·kg-1·h-1,with the patients on intravenous fluids and receiving nutrition by mouth and vein. The levels of serum leptin, 8-iso-prostaglandin F2α (8-iso-PGF2α, the activities of superoxide dismutase (SOD), total antioxidant capacity (TAC) and the contents of malondialdehyde (MDA) in 96 patients with hyperglycemia crisis on admission and after insulin therapy with resolution of hyperglycemia and ketoacidosis (72 hours) were measured. Another 35 healthy individuals served as normal control. Results The activities of SOD, TAC and the levels of leptin before treatment were lower in patients with hyperglycemia crisis than in normal controls, and the levels of MDA and 8-iso-PGF2a were more markedly elevated than those in normal controls (all P<0. 05). The activities of SOD, TAC and the levels of leptin in patients after treatment were significantly higher than those in patients before treatment, and the levels of MDA and 8-iso-PGF2a. were significantly lower than those in patients on admission (all P<0. 05). There was significant positive correlation between leptin and MDA in patients before treatment (r=0. 38, P<0. 05), and the level of leptin was negatively correlated with MDA and 8-iso-PGF2a in patients after treatment (r1 = - 0. 35, r2= - 0. 37, both P < 0. 05). In stepwise regression analysis, MDA and 8-iso-PGF2α showed a significant association with leptin. Conclusion The levels of leptin are significantly lowered in patients with hyperglycemia crisis. Oxidative stress may participate in determining the leptin level in hyperglycemia crisis.
